Walnut Creek Workers’ Compensation Attorney

When you go to your job, you expect to do your work, get paid, and come home safely. Most days, this is exactly what happens. But every day, workers throughout California are hurt on the job or are diagnosed with an occupational illness.

Under California law, employees who suffer workplace injuries and occupational diseases are entitled to certain benefits known as workers’ compensation. Employers are required to maintain workers’ compensation insurance or be approved for self-insurance, to cover workplace accidents and illness claims. In 2019 alone, 699,120 claims for workers’ compensation were filed in California.

Workers’ compensation is a no-fault system. This means that if you were injured on the job or develop an occupational disease, it typically does not matter who was to blame for the accident. When an injury or illness occurs in the course and scope of employment, you may be eligible for:

  • Payment of medical expenses
  • Payment of two-thirds of normal pre-injury monthly salary
  • Payment of job retraining
  • Payment of living expenses while unable to work

If you have been hurt at work or diagnosed with an occupational illness, a workers’ compensation lawyer can help. At the Appel Law Firm, our team of attorneys has more than 60 years of combined experience representing injured workers. We offer free initial consultations to all prospective clients so you can learn about your rights and options for pursuing a workers’ compensation claim.

California Workers’ Compensation Laws

Workers’ compensation claims are handled through the California Department of Industrial Relations, Division of Workers’ Compensation. Under California’s workers’ compensation laws, an employee who is hurt on the job must be allowed to file a workers’ compensation claim. Employers are required to supply claims forms,  Form DWC-1, to employees, along with information about workers’ rights and potential eligibility for benefits. 

Employees have five years from a specific date of injury to file Form DWC-1 to begin a workers’ compensation claim. By filing this form, workers may be entitled to up to four types of benefits: (1) medical; (2) temporary disability; (3) permanent disability; and (4) supplemental job displacement. For family members whose loved ones died as a result of a workplace injury or illness, death benefits may also be available.

Under the Workers’ Compensation Act, employers must authorize payment for medical treatment even if they are investigating the claim. The employer is responsible for up to $10,000 in medical bills until a decision is made about the validity of the claim. If the employer or its insurer does not deny a claim for benefits within 90 days of submission of the form, then it will be considered approved.

In addition to medical benefits, employers are also required to provide temporary disability benefits within 14 days of learning of a worker’s injury or illness. If the employer or insurance company fails to do so, then they will be assessed a 10% late payment penalty.

Who Can File for Workers’ Comp Benefits?

To be eligible for workers’ compensation benefits, you must have suffered an injury or been diagnosed with an illness that arose out of or in the course of employment. Generally, this means that the injury or illness must have occurred while you are at work. This may include an injury suffered during an auto accident while driving to a job site or meeting, but not one that occurred during your regular commute to work.

A work-related injury includes any injury or disease that arises out of employment, including psychiatric or mental health conditions. There are two basic types of workplace injuries covered by California’s workers’ comp:

  1. Specific injuries, which are the result of one incident, such as hurting your back while lifting something.
  2. Cumulative injuries, which are caused by something that occurs over time. For example, repetitive motions may cause carpal tunnel syndrome.

To qualify for workers’ compensation benefits, you must be an employee, not an independent contractor. California recently enacted a law that made it more difficult for employers to misclassify employees as independent contractors. If you believe that your employer has misclassified you as an independent contractor, a workers’ compensation lawyer can help you fight for proper classification and to get the benefits that you are entitled to under the law.

In California, nearly all people employed are covered under workers’ compensation laws. This includes immigrants, minors, people that work part-time, and permanent residents. Some types of employees are not covered though, such as domestic workers in private homes, and people that are self-employed. The vast majority of people working in California, however, are considered to have coverage.

Common Workplace Injuries 

A work-related injury can happen at almost any job site, in any industry, from construction to ironworking to shipping to manufacturing. While we often think about work injuries as a traumatic event, such as an accident or a fall, a person may be injured in any number of ways. As injury attorneys, we have helped people with: 

  • Amputation of limbs, fingers, and toes
  • Burns from chemical exposure and explosions
  • Brain injuries
  • Spinal cord injuries
  • Back and neck injuries, including herniated lumbar or cervical disks
  • Fractured bones
  • Crushing injuries
  • Hearing loss
  • Any serious injury resulting in surgery and extended disability
  • Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), and other chronic pain conditions
  • Fatal injuries/death
  • Exposure to toxic substances (such as asbestos)

However you were hurt, if your injury or illness is linked to your job, then you may be able to file a claim for workers’ compensation.

How to File for Workers’ Compensation in California

There are several steps that you must take in order to file a workers’ compensation claim. It can be a tedious process, but if you have been injured at work and you are unable to return to your current duties, filing for workers’ compensation is the only way that you can recover your lost wages. To start the process, you will be required to fill out certain forms and then give them to your employer so that they can fill out their portion.

Under the California Labor Code, injured employees must notify their employer in writing within 30 days of their injury. If your employer learns about your injury in some other way, then that can substitute for written notice. Failure to provide notice generally will not prevent you from recovering benefits, unless the delay causes some negative consequences for your employer.

Within 1 working day of learning about your injury, your employer must provide you with Form DWC 1. You will be required to provide certain information on the form, including:

  • The date and time of the injury
  • Address and description of where the injury occurred
  • Description of the injury and the body part(s) affected
  • Personal information, including your Social Security number

Remember to put as much detail as possible on this form. The more information you can provide on this form, the easier it will be for a claims administrator to review your claim.

Importantly, making a false or fraudulent workers’ compensation claim is a felony. If you are convicted of workers’ compensation fraud, you could be sentenced to up to 5 years in prison, and/or a fine of up to $50,000 or double the value of the fraud, whichever is greater. When filling out this form, be sure that what you write is accurate and truthful.

After you complete the Form DWC 1, return it to your employer. They will then need to complete the form, providing information on their insurance policy, when they learned of the injury, and other details. Your employer will then send the form to their insurance company.

If your claim is denied or you disagree with the insurance company’s decision, then you may file an Application for Adjudication of Claim at the Workers’ Compensation Appeals Board office closest to you. A seasoned California workers’ compensation attorney can help you with the process, including representing you at a hearing before a workers’ compensation judge.

How Workers’ Compensation Benefits Are Paid

Workers’ compensation benefits provide payment for: 

  • medical expenses you incur as a result of your workplace injury. These dollars are paid directly to the healthcare provider who administered the care. Unlike traditional insurance benefits, there will be no out-of-pocket medical costs for a work-related injury. 
  • lost income as a result of time away from work or decreased ability to work. In California, these dollars total two-thirds of your regular income (not including overtime) paid directly to you for each day that you are away from work due to injury. If you can work but your hours are limited due to your injury, workers’ compensation will pay out two-thirds of what you would have earned in the remaining hours. 

For lost wages to be covered by workers’ comp, your doctor must require you to take time off of work due to your injury. If you fail to return to work when your physician releases you, you will be required to repay any benefits paid for the time you were released and not working.

What Costs Does Workers’ Compensation Cover?

In California, workers’ compensation benefits cover three specific types of costs: medical treatment, lost wages (disability), and retraining. If a worker dies due to a work-related illness or injury, then workers’ comp will provide death benefits to their survivors.

Californians can receive medical benefits that are necessary to cover the costs of workplace injuries. This includes costs for doctor’s visits, surgeries, medications, and any additional costs you may incur during treatment, such as purchasing a wheelchair or crutches. Finally, medical care costs also cover any rehabilitation care you may need to recover from your injury.

In addition to medical care payments, workers’ compensation in California also provides money for lost wages in the form of temporary and/or permanent disability benefits. These benefits may include:

  • Total Temporary Disability Benefits:  Total temporary disability is payable when you are not able to work because of temporary restrictions that your doctor has established for you. In other words, although you cannot work right now, your doctor believes you will be able to go back to work once you fully recover.
  • Temporary Partial Disability:  If you are temporarily partially disabled, then your compensation will match the extent of your limitations due to your disability. For example, if your doctor only allows you to work five hours out of each eight-hour day, you will receive benefits proportional to the three hours of work each day that you cannot stay at your job.
  • Permanent Partial Disability: After you have reached your maximum medical improvement, and are still partially disabled, you will be able to receive some benefits, even if you can return to work with limitations.
  • Permanent Total Disability: If you cannot return to employment because of a disability that will not improve with time, you may be eligible for total disability benefits. You do not need to be totally debilitated to receive benefits in California but only injured to such an extent that you cannot ever return to work.

In addition to disability benefits, you may also be entitled to supplemental job displacement benefits in the form of retraining. If, after a certain amount of time you have discovered that (1) your disability is permanent; (2) you will be unable to return to your previous work; (3) and your employer has not offered you any alternatives, you can qualify for a $6,00 voucher for job training classes so that you can learn a new skill.

Finally, survivors of an employee who dies as a result of a work-related injury and illness may receive workers’ compensation death benefits. The amount of death benefits is based on the number of people who were dependent on the deceased worker and may be as high as $320,000. In addition, workers’ compensation will pay for up to $10,000 in funeral or burial expenses. 

How Long Does Workers’ Compensation Last?

Workers’ compensation will replace two-thirds of your lost income through their temporary disability program 1) for the duration of your time away from work due to workplace injury or illness, OR 2) for two years, whichever is less. However, permanent disability may be available based on the severity of your injury.

As soon as your doctor releases you to return to work, even on modified duty or fewer hours, you must return to work. Otherwise, you may have to pay back the benefits that you received.  If your injury is serious enough to cause permanent disability, meaning you can never return to work or will always suffer the effects of the injury, workers’ compensation will replace your income for two years before your case transitions to permanent disability. Permanent disability payments vary significantly depending on the degree of disability. These payments can last for the remainder of your life, and in some cases, can be paid out in a single lump sum.

Why Choose Appel Law Firm LLP?

Our Walnut Creek, California law firm offers practitioners of worker’s compensation law in the state. We have handled hundreds of cases since 1995. Work Comp Attorneys Joseph Appel, Joseph L.J. Appel and Thomas Appel frequently appear before the Workers Compensation Board, advocating for injured workers.

Our law firm has experience handling even the most difficult claims. As personal injury attorneys, we also help people recover compensation from third parties (not their employers) who may have contributed to the accident that caused their injury. In this event, a civil lawsuit can be filed in Superior Court to achieve full compensation for the injured worker, as opposed to only receiving workers’ compensation benefits.

Don’t get lost in a stack of claims sitting on an inexperienced lawyer’s desk somewhere. Get personal attention and peace of mind while you heal. You want a legal team that pursues your case from day one, goes to bat for you, and proves your case so you get the compensation you deserve and need. If you don’t win, we don’t win, and we don’t get paid our attorney fees.

Workers Compensation Frequently Asked Questions

What is Workers’ Compensation?

Workers’ compensation in California is the legal system by which workers who suffer on the job injuries receive temporary compensation benefits, medical care and treatment benefits, and occasionally partial or total permanent disability benefits.

What are Workers’ Compensation Benefits?

The insurance companies provide and pay for medical care and treatment for the cure or relief of industrial injuries. The insurance companies also pay highly regulated temporary disability benefits, and if applicable, partial or total permanent disability benefits.

What if You’re Injured at Work?

Report the accident immediately to a supervisor, fill out the appropriate work comp claim form, and report immediately to a medical doctor at which time you should document ALL of your injuries, no matter how minor to the doctor for record keeping and treatment. As soon as you can thereafter, you should the seek the services of a trained workers compensation for a private, independent consultation as to your potential rights under the California worker’s compensation system.

Can You Be Fired for Being Injured at Work?

Your employer cannot fire for proposing to file, or filing, a workers’ compensation claim. Such a firing is illegal under Labor Code Section 132(A). Any employer who does so is subject to severe penalties payable to the injured worker

What If Your Work Injury is Caused by a Third Party?

If your injuries are caused by someone other than your co-workers at your company you may have what is known as a third-party case. A third party case is filed in the superior courts of the state of California and you are allowed to seek full relief, including past and future medical bills, past and future losses of earnings, and past and future pain, suffering, inconvenience, humiliation, and emotional distress.  Third party cases need to be analyzed as soon as possible with the assistance of a trained attorney.

Hurt at Work? We Can Help.

Workers’ compensation cases may seem straightforward, but they can often be incredibly complex. An insurance company may refuse to pay for certain medical treatment, push you to go back to work before you are ready, or even deny your claim outright. In these situations, you need a skilled workers’ comp lawyer to help you get the full amount of benefits that you are entitled to under California law.

Based in Walnut Creek, throughout the greater San Francisco areas, including Contra Costa County and Alameda County. We offer free initial case evaluations, and never charge a fee unless we recover money for you. To learn more or to schedule a free consultation about your workers’ compensation claim, call us today at (925) 938-2000 or fill out our online contact form

Let Us Help You

Brad L., Oil Refinery Operator

Feeling confident that our case was being well-handled eased a lot of stress during a difficult time. Joe was very generous with his time and expertise in our workers comp case and was always there to answer any questions

Don’t get lost in a stack of claims sitting on an inexperienced lawyer’s desk somewhere. Get personal attention and peace of mind while you heal. You want a legal team that pursues your case from day one, goes to bat for you, and proves your case so you get the compensation you deserve and need. We’re that team, your team. If you don’t win, we don’t win, and we don’t get paid our attorney fees.

Contact us for a free consultation regarding your workers’ compensation claim.

NOTICE—making a false or fraudulent workers’ compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

Want to learn more? Read our Workers' Compensation FAQ’s on our blog.